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General NPI Number Information
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NPI Number | 1104138486
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Entity Type | Organization
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Legal Business Name | ATHLETIC & THERAPEUTIC INSTITUTE OF MILWAUKEE LLC
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Dates
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Enumeration Date | 07/02/2010
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Last Update Date | 02/10/2026
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Provider Practice Location Address
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Address Line | 6810 W STATE ST
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City | WAUWATOSA
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State | WI
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Zip | 53213-2807
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Country | US
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Telephone | 414-259-0623
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Fax | 414-259-0746
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Provider Business Mailing Address
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Address Line | 2001 BUTTERFIELD RD STE 1600
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City | DOWNERS GROVE
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State | IL
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Zip | 60515-1211
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Country | US
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Telephone | 630-296-2223
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Fax |
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Authorized Official
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Title or Position | CHIEF COMPLIANCE OFFICER
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Name | WADE A MEYER
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Credential |
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Telephone | 630-296-2223
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number |
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License Number State | WI
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